Epidemiology And Etiology

There are an estimated 150,000 cases of SE each year in the United States, with approximately 55,000 associated deaths, and an estimated annual direct cost for inpatient admissions of $4 billion.4,5 SE occurs more frequently in African Americans, children, and the elderly.

It is important to understand the underlying cause of SE, as this will guide the course of treatment, potentially shortening the duration of SE and improve outcomes. The causes of SE can be categorized as acute or chronic. Acute changes that cause SE include metabolic disturbances; CNS disorders, infections, or injuries; hypoxia; drug toxicity (e.g., theophylline, isoniazid, cyclosporine, cocaine); or acute illness. Chronic processes that cause SE includes pre-existing epilepsy, chronic alcohol abuse (withdrawal seizures), CNS tumors, and strokes.3 In epileptics, the common causes of SE are anticonvulsant withdrawal or subtherapeutic anticonvulsant levels. Patients with SE due to chronic processes generally respond well to antiepileptic drug (AED) therapy.

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